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News

Metal stents safer than prostheses for dysphagia

Results in November's Journal of Clinical Gastroenterology indicate that metal stents vs plastic tubes in malignant dysphagia have a marginal clinical benefit, are safer and are associated with a prolonged improvement of dysphagia score.

News image

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Malignant dysphagia due to esophagogastric cancer is associated with poor overall prognosis.

Placements of self-expandable metal stents or plastic tubes are established methods as palliative treatment options.

As an alternative and/or complementary therapy, radiologic technique and locally endoscopic techniques are often used.

Dr Axel Eickhoff and colleagues conducted a retrospective trial of 153 patients treated in their department between 1993 and 2001.

The researchers reported that 45 patients in Group A received a plastic tube, and 108 patients in Group B were treated with metal stents.

Both groups were compared for improvement of dysphagia score, survival, recurrent dysphagia and complications.

Median survival time after insertion was 78 days with the tubes and 113 days with the metal stents
Journal of Clinical Gastroenterology

The research team found that stent placement was successful in 93% of patients of Group A and 99% of Group B.

The team noted that the median dysphagia score improved significantly in both groups.

Recurrent dysphagia was noted in 27% patients of Group A and 25% patients of Group B.

Median survival time after stent insertion was 78 days in Group A and 113 days in Group B.

The research team observed overall complications in 33% of patients in Group A and 26% of patients in Group B.

However, the team noted that there were significantly more major complications in Group A than in Group B.

Dr Eickhoff's team concluded, “Our results indicate a marginal clinical benefit for metal stents versus plastic tubes in malignant dysphagia in the long run.”

“However, metal stents seem to be safer and associated with a prolonged improvement of dysphagia score.”

J Clin Gastroenterol 2005: 39(10): 877-85
14 October 2005

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